title: Can a Mediterranean diet reduce the effects of lipodystrophy syndrome in people living with HIV? A pilot randomised controlled trial.
abstract: BACKGROUND
  HIV and highly active antiretroviral therapies have been associated with changes in individuals' lipid profiles and fat distribution (lipodystrophy). A pilot study was conducted for a randomised controlled trial to evaluate whether lipodystrophy in HIV patients can be controlled by adopting the low-fat and low-cholesterol diet or the modified Mediterranean diet.
  
  
  METHODS
  Forty-eight HIV patients were randomised into two diet groups. Thirty-six (75%) completed the 1-year pilot study with regular dietetic consultations, during which time lipid levels, weight, body mass index and fat distribution were recorded. Differences between and within groups were determined.
  
  
  RESULTS
  Undesirable body fat changes in the low-fat diet group included decreases in tricep skinfold (from 19.9 mm to 15.4 mm (P = 0.03)), hip circumference (from 93.6 cm to 91.7 cm (P = 0.01)) but a significant increase in waist-to-hip ratio (from 0.87 to 0.89 (P = 0.003)). Serum cholesterol increased significantly in the Mediterranean diet group at 9 and 12 months (from 4.6 to 5.06 mmol L(-1) (P = 0.03) and 5.12 mmol L(-1) (P = 0.01)) with no obvious change in the low-fat diet group. Serum triglyceride levels remained the same in the Mediterranean diet group, whereas it increased from 1.9 to 3.22 mmol L(-1) (P = 0.07) in the low-fat diet group.
  
  
  CONCLUSIONS
  A Mediterranean diet seems to have an advantage over the low-fat diet in maintaining serum triglyceride levels and avoiding lipodystrophy, but this advantage was offset by a rise in cholesterol level. Several procedural and methodological issues were identified which must be rectified before a similar large-scale trial taking place.
authors.affiliation: Department of Dietetics, Queen Elizabeth Hospital, Kowloon, Hong Kong. cnwbg01@ha.org.hk
authors.forename: Geraldine Wai Bik
authors.initials: GW
authors.lastname: Ng
authors.forename: Una Man Shu
authors.initials: UM
authors.lastname: Chan
authors.forename: Patrick Chung Ki
authors.initials: PC
authors.lastname: Li
authors.forename: William C W
authors.initials: WC
authors.lastname: Wong
mesh_terms: D000328:Adult; D002784:Cholesterol / Q000097:blood; D018752:Diet, Fat-Restricted / Q000706:statistics & numerical data*; D038441:Diet, Mediterranean / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000178:diet therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000178:diet therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood*
chemical_list: D014280:Triglycerides; D002784:Cholesterol